甲状腺机能亢进症患者血清骨钙素变化的研究

Study of Serum Osteocalcin Levels in Patients with Hyperthyroidism

为探讨甲状腺机能亢进症时 ,高甲状腺激素水平对血清骨钙素的影响 ,本文对 87例甲状腺机能亢进患者及 5 2名健康志愿者采用放射免疫法测定了血清骨钙素 (OC)、FT3、FT4 和TSH。结果显示 :健康志愿者血清骨钙素水平随着年龄的增高而逐渐降低 ;男女性别间经统计学处理无显著性差异 (P >0 .0 5 )。各年龄组甲亢患者治疗前OC浓度明显升高 (P <0 .0 0 1) ,经抗甲状腺药物治疗甲亢症状缓解后 ,血清OC浓度也降至正常 ;相关统计分析表明 ,甲亢治疗前、后血清OC与FT3、FT4 之间呈明显的正相关 (FT3:r =0 .84- 0 .2 7 P <0 .0 1;FT4 :r=0 .5 8- 0 .2 9 P <0 .0 1) ;与TSH无相关性。结论 :甲状腺激素可能直接参与加速骨转换过程 ,并以增加骨吸收过程为显著 ,导致骨量丢失 ;提示血清OC可以作为甲亢所致骨代谢改变的诊断及其疗效观察的敏感指标之一。

In order to study the serum osteocalcin(OC) level in hyperthroidism, serum osteocalcin, FT 3, FT 4 and TSH were measured by radioimmunoassay in 87 patients with hyperthyroidism and 52 healthy volunteers. The results indicated that the serum osteocalcin level was decreased with age increase in healthy volunteers and there was no significant difference in sex(P>0.05). Serum concentration of OC was significantly higher in untreated hyperthroid patients than that in healthy volunteers (P<0.001). After therapy for hyperthyroidism, OC level returned to normal. The correlation analysis showed that OC was positively correlated with FT 3, FT 4(FT 3:r=0.84-0.27, P<0.01; FT 4:r=0.58-0.29,P<0.01), but not with TSH. Conclusion: Thyroid hormones might speed up bone turnover directly with increased bone resorption to induce bone mass loss. These results indicate that OC is a highly sensitive marker for altered bone metabolism in hyperthyroidism.